论病案管理者角色的转变

新时期给病案管理者带来了机遇和挑战,也对病案管理者的业务素质提出了更高的要求.在新形势下,病案成为越来越重要的法律文档,病案管理人员要加强法律意识,从被动服务转变为主动服务,主动地去适应角色的转变.     

以课堂教学质量控制为中心 加强全面质量管理

随着素质教育实施和教学改革的不断深入，我校办学规模和层次在逐步扩大，到2002年，我校的办学专业增加到6个，分大专、中专两个层次，在校学生人数达1895人。在这种情况下，为提高整体教学质量，学校在原来教学管理的基础上，将企业全面质量管理的理念引入到教学管理中，使教学质量的管理与控制由过去部门零散工作变成了全校的系统工程。     

护士在ICU患者疼痛管理中的作用

疼痛是许多疾病共有的症状,严重危害患者的生理和心理健康,尤其是ICU患者,疼痛甚至造成功能障碍。本文通过探讨疼痛对机体的影响和疼痛管理在ICU患者中的意义,阐述护士在ICU患者疼痛管理中的重要作用。     

膳食干预在社区老年高血压管理中的作用

目的探讨膳食干预在社区老年高血压管理中的作用。方法选择2009年10月～2011年10月在我社区服务中心就诊的108例首次被确诊为高血压的老年患者为研究对象,运用随机数字表法将其分为对照组和观察组,对照组患者仅进行常规药物治疗,而观察组患者在上述药物治疗的基础上给予膳食干预,分别于确诊为高血压时及3个月后进行自行设计问卷调查。比较两组患者高血压相关知识的了解、血压达标及生活方式改变情况。结果对照组患者在高血压相关知识的了解及血压达标上明显低于观察组患者,差异有统计学意义（P〈0．05）,而对照组和观察组患者在生活方式改变上差异无统计学意义（P〉0．05）。结论在社区服务中心对老年高血压患者进行治疗的过程中,膳食干预明显增加老年高血压患者高血压相关知识的了解,并且改善其生活方式,从而提高老年高血压患者的血压达标率,值得在各大社区服务中心推广运用。     

The role of laparoscopy in the management of the impalpable testicle

Background  

Laparoscopy can identify patients who would benefit from further surgical intervention. Most importantly it is 100% sensitive in identifying the vanishing testicle.     

The role of corticosteroids in the management of childhood asthma

Preventive treatment: * Inhaled corticosteroids are indicated in children with asthma who have more than mild persistent asthma or are unresponsive to non-steroidal medications after 2-4 weeks. * Initial administration of 400 microg/day of chlorofluorocarbon-beclomethasone dipropionate, or budesonide, or 200 microg/day of fluticasone propionate or hydrofluoroalkane-beclomethasone dipropionate, is suggested, with subsequent titration of the dose to achieve ongoing control with the lowest dose possible. * In situations where asthma control cannot be achieved with the above doses of inhaled corticosteroids, the addition of a long-acting beta2-agonist, theophylline or a leukotriene antagonist should be considered. * Specialist referral is recommended in children requiring high doses of inhaled steroids, regular oral steroids or in whom there is concern about possible steroid side effects. Treatment of acute asthma: * Systemic corticosteroid therapy is recommended for children with moderate to severe acute asthma or if there is incomplete response to beta2-agonists. * Initial administration of 1 mg/kg prednisolone (maximum, 50 mg) orally is suggested, and this may be repeated every 12-24 hours, depending on response. While a course of up to three days is generally sufficient, in more severe cases a prolonged course (with tapering) may occasionally be indicated. * The need for recurrent systemic corticosteroid therapy for acute episodes is an indication for reassessment of the child's interval therapy.     

The role of radioimmunodetection in the management of testicular cancer

Five patients with testicular cancer received an intravenous injection of between 1 and 2.5 mCi of iodine 131-labeled antibody to human chorionic gonadotropin (HCG) or alpha-fetoprotein (AFP), followed by total-body photoscanning to visualize areas of abnormal radioactivity. Blood-pool and nontarget sites of radioactivity were reduced by subtracting the images derived by injection of technetium Tc 99m-labeled components from the iodine 131 scans. The HCG-immune scintiscans proved helpful in tumor localization and in the selection of appropriate therapy, while the AFP scan presented corroborative evidence of widespread tumor. Elevated serum levels of these two markers did not hinder successful tumor detection and localization by this method of radioimmunodetection. Cancer radioimmunodetection with antibodies to HCG and to AFP appears to be a useful procedure for the pretreatment and posttreatment evaluation of patients with testicular cancer and can reveal sites of tumor not detected by other methods.     

The role of laparoscopy in the management of the infertility patient

Laparoscopy has traditionally been used only as a diagnostic step in the evaluation of the infertility patient. With the advent of more sophisticated instrumentation including the use of laser surgery, laparoscopic procedures can now be performed instead of conventional laparotomy. Lysis of pelvic adhesions as well as treatment of endometrial implants and endometriomas are now routine laparoscopic procedures with improvement in pregnancy rates comparable to microsurgery. New advances in instrumentation will increase the pregnancy rate following laparoscopic tubal surgery as well as laparoscopic assisted in Vitro Fertilization, and will also increase the safety of this procedure.